1. பிறப்பொக்கும் எல்லா உயிர்க்கும் சிறப்பொவ்வா செய்தொழில் வேற்றுமை யான்.
பிறப்பொக்கும் எல்லா உயிர்க்கும் சிறப்பொவ்வா செய்தொழில் வேற்றுமை யான்.

2. ASI Chennai City Branch
Welcomes you all

4. CYSTIC SWELLINGS OF THE NECK
Prof.Dr.D.Nagarajan M.S

5. CLASSIFICATION 1.Cytic hygroma POSTERIOR TRIANGLE; MIDLINE SWELLING:
1.Sublingual dermoid
2.Thyroglossal cyst
3.Subhyoid bursitis
LATERAL SWELLINGS;
1.Digastric triangle -plunging ranula
2.Carotid triangle -bronchial cyst
POSTERIOR TRIANGLE;
1.Cytic hygroma

6. Fibrous cyst that forms from a persistent thyroglossal duct
midline swelling with slight inclination to left
Out pouching from floor of first and second bronchial pouch
THYROGLOSSAL CYST

7. pseudo stratified columnar epithelium with lymphoid tissue, fluid is formed by un- obliterated duct it contains cholesterol crystals
tubulo-dermoid type
may contain thyroid tissue /only functiong thyroid tissue
age yrs of females

8. COMMON SITES SUBHYOID -MC THYROID CARTILAGE SUPRAHYOID
FLOOR OF THE MOUTH
BENEATH TH FORAMEN CAECUM

9. SYMPTOMS: Painless Oval in shape Gradually increased in size Skin free
Occasionally -Translucent
mobility-sideways
Moves on protrusion of tongue
Fluctuant
Lymph node enlarged if infected
Examine the base of the tongue

10. COMPLICATIONS: INVESTIGATIONS: Recurrent infection fistula formation
Malignancy
Cosmetic
In advent surgery
INVESTIGATIONS:
USG thyroid/MRI
FNAC
Uptake studies

11. DIFFERENTIAL DIAGNOSIS
Subhyoid bursal cyst
Sublingual dermoid
Enlarged cervical node
Ectopic thyroid
Solitary nodule from isthmus

12. Excision-track with body of hyoid bone
TREATMENT:
Excision-track with body of hyoid bone
Sistrunk’s operation

13. SUBLINGUAL DERMOID Sequestration dermoid
Entrapped ectoderm level of first or mandibular arch
Above or below mylohyoid
Lined by squamous epithelium/
Contain -sweat glands/sebaceous glands
Cheesy materials
It never contains hair

14. SUBLINGUAL DERMOID Occurs at 10-15 years Male= female
Position :supra omohyoid or sublingual variety
Under the tongue or beneath the chin
Mucosa free/ fluctuation positive
non -Transillumination
Intra omohyoid or cervical variety
bimanual palpation

15. Sublingual drmoid cyst
Investigation - USG /MRI/FNAC
Treatment- excision under GA(intra/extra oral)

16. BRONCHIAL CYST
congenital cyst persistence of second bronchial cleft ecto derm
At the upper part of sternocleidomastoid
Posteromedial part in the deeper plane
Oval in shape
Smooth surface /soft
Well-defined
Fluctuation positive
Trans illumination negative

17. Cholesterol crystals on aspirated fluid
BRONCHIAL CYST
not reducible/compressible
Cholesterol crystals on aspirated fluid

18. BRONCHIAL CYST
COMPLICATIONS: Cosmetic Infection fistula formation DIAGNOSIS: FNAC MRI/FISTULAGRAM TREATMENT: Excision

19. Course BRANCHIALCYST
Subcutaneous at the level of upper border thyroid cartilage
Pass through bifurcation of common carotid artery
Superficial to internal carotid,deep to ext.carotid
Deep to the post.belly of digastric and stylohyoid muscle
Superficial to IJV,hypoglossal,glossopharyngeal nerves
Pierces the sup.constrictor ,open behind post.pillar of the tonsil.

21. The Neck of the cyst passes between the int and ext carotid art.
Rx:Excision ( STEP - LADDER OPERATION )
The Neck of the cyst passes between the int and ext carotid art.
Can Recur.

22. op

23. Ranula Cystic swelling floor of mouth
Mucous extravasation from sublingual salivary gland
Plunging Ranula, extend through FOM muscles into neck

24. The name is derived form the word rana, because the swelling may resemble the translucent underbelly of the frog.

25. Plunging ranula Penetrates Mylohyoid muscle to enter neck
Soft painless fluctuant dumb- bell shaped swelling
Bi digital palpation

26. Plunging ranula Rare form of retention cyst May arise from SM/SL SG
Mucous collects around gland
Surgical excision via neck

27. CYSTIC HYGROMA Arises from jugular lymph sac 6th to 14th week
sequestration of lymphatic sac
Multiloculated
Lined by endothelium
Posterior triangle of neck
Ascends to ear lobule or descends to axilla
Early infancy or at birth presentation
Lump in the lower third of posterior triangle

28. CYSTIC HYGROMA Increases in size smooth Indistinct margin
Smooth or lobulated
Cystic consistency
Impulse on coughing
Can be compressible
Translucent brilliantly

29. CYSTIC HYGROMA TREATMENT: COMPLICATIONS: Cosmetic
Respiratory difficulty
Infection following incomplete removal
Recurrence
INVESTIGATIONS:
MRI
TREATMENT:
Sclerotherapy
Hot water injection
Subsequent RT for recurrence

30. Subhyoid bursal cyst
Enlargement subhyoid bursa with accumulation fluid
Below the hyoid bone/front of the thyrohyoid membrane
Swelling with pain
Oval with long axis(cf.thyroglossal cyst)
Mid line /move with deglutition
Cystic/fluctuation +/non- transillumation /turbid

31. Subhyoid bursal cyst Investigation TREATMENT
MRI/FNAC
TREATMENT
Complete excision-transverse incision

32. THANKS TO MY TEACHERS PROF.DR.S.NARENDRAN M.S Ph.D
TANJAVUR MEDICAL COLLEGE
PROF.DR.A.SUKUMAR M.S
Rtd. Director of Medical and Rural services
PROF.DR.C.M.K REDDY FRCS
Rtd. Prof. Stanley Medical College
PROF.DR.T.MOHANA PRIYA M.S
Sri Ramachandra Medical College and R.I

33. The wood is lovely dark and deep
But I have promises to keep
Miles to go before I sleep

34. thankyou